What NOT to Do When Your Patient is a Colleague

Health care professionals who are endocrinologists, cardiologists or who work in these specialized fields know the complications of prediabetes or diabetes. Many of us have these patients. Sometimes it’s almost natural to talk with these patients differently than we’d talk with most of our patients who aren’t as well-educated.

A woman, 59 years of age with prediabetes and strong history of cardiovascular disease complained of a slight chest pain not associated with exertion or shortness of breath, just an ongoing discomfort. Other than this, the patient — who is herself a health care provider — is feeling fine. This patient does have a history of hypertension. Lipids are excellent, including an HDL>60, Triglycerides 75, LDL 78. A1C 5%, and BP is 108/76-HR 84. Due to this fact the cardiologist, who by the way is a colleague of the patient’s, recommended further testing, including a cardiac CTA, because “women do present atypically.”

The patient went for an exam. The patient’s cardiologist received the report shortly before going on vacation. The cardiologist called the patient who answered the phone. The cardiologist did not say, “Hello.” Instead, just, “You’ve got a bad disease.” The patient’s response was she thought the cardiologist was kidding and said, “You’re kidding.” The response was, “No, you’ve got a bad disease. Your calcium score was very high.” The patient was on aspirin, a statin was added and a nuclear stress test was scheduled for the next opening — 3 weeks from the call. Although the patient was a health care provider, she wanted more answers, but when she called back, the cardiologist was gone off on vacation.

The next day, the patient called the office and the covering cardiologist saw the patient. This cardiologist read the report, explained the findings, including drawing pictures, and reassured the patient that the “disease” may actually not be that bad. A number is a number and to relieve the patient’s anxiety, a nuclear stress test was scheduled for the next day. The cardiologist’s parting words were, “You’ll be fine.” The patient felt much better. Even knowing the risks, she felt hopeful, not hopeless.

Lessons Learned:

When your patient is a health care provider, remember, they are also a patient, a person, not different than your other patients, other than perhaps more knowledgeable. Communicate sensitive matters with these patients as you would other patients who are not health care providers. Because they may be knowledgeable, it is best to get answers as soon as possible to help alleviate stress.

If you have bad or surprising news to share with a patient, don’t do it when you are in a hurry.

Always offer hope.

Anonymous

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